Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 20A15013 | CA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 20A15013 | CA |
NPI | 1285185389 |
---|---|
Provider Name | Dr. Nilofar Sanaiha |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Santa Monica, CA 90404-1135 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2016 |
Last Update Date | 02/10/2019 |